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COPD, COPD Assessment Test, nurse practitioner-led quality improvement, quality improvement project, improve COPD symptom management



  1. Abrams, Meghan E. DNP, NP-C (Family Nurse Practitioner Pulmonary and Critical Care)


Background: The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) is a questionnaire used for COPD symptom assessment that is valid, reliable, and evidence based; yet, few specialty or primary care practices have formally implemented it in practice.


Local problem: The University of Colorado's pulmonary division has consistently been rated the best in the country by US News and World Reports; however, the dedicated multidisciplinary COPD clinic at the University had yet to formally implement any COPD Assessment tools for COPD symptom management. This quality improvement project focused on the successful implementation of the CAT for management of COPD and whether its use impacts symptom management.


Methods: Plan-Do-Study-Act cycles were used to implement the CAT questionnaire in the outpatient COPD clinic from April 16 to September 30, 2019. Weekly retrospective chart evaluation was completed to evaluate CAT completion, documentation, and associated medical intervention rates. Weekly patient phone surveys were completed on qualifying COPD patients to garner patient opinion on the utility of the CAT in symptom management.


Interventions: The CAT was administered to all COPD patients in University of Colorado Hospital's COPD clinic. Cat-themed signs, decorations, and treats were provided to staff on COPD clinic days to increase staff buy-in.


Results: The CAT was completed on 217 of 245 (89%) patients with COPD. Of patients surveyed, 81% (n = 53) noted that their symptoms were better managed after CAT implementation.


Conclusions: Implementation and utilization of COPD assessment tools, like the CAT, are practical and sustainable in a specialty practice setting. Moreover, the CAT helps with COPD symptom management.